As recently as the early 1990's, surgical operations for trauma were directed at the anatomic repair of all injuries at time of the initial operation. It was observed during these exercises that many patients became hypothermic, acidotic, and coagulopathic. Patients showing these three signs often died. Death often occurred in the operating room due to exsanguinations, or postoperatively, due to the complications of prolonged shock and massive transfusion to replace blood lost as a result of the trauma.
One of the most notable developments in the recent evolution of surgery has been the introduction of the concept of staged laparotomy to overcome the deficiencies of the repair all-at-once approach. This new strategy of staged laparotomy, employing new tactics that have been termed damage control, is now used in 10% to 20% of all trauma laparotomies.
This damage control strategy opens the way for a variety of new devices and methods for a) control of hemorrhage from solid organs or viscera, b) control of hemorrhage from peripheral wounds and peripheral vascular lacerations, and c) control of contents spillage from hollow viscera. Although there are procedures for controlling these injuries, none of these procedures utilize optimal devices or tactics in their execution. Each area offers technological opportunities to improve the devices and procedures for applying those devices.
There are situations, especially in the battlefield, where soldiers are placed at risk for penetrating injuries from bombs and projectiles. Soldiers are often equipped with body armor. However, this body armor generally protects the torso but not the arms, legs, and neck in the region where body flexibility is required. Thus, soldiers often incur injuries to the region just adjacent to the body armor, wherein such injuries are difficult to treat, hemorrhage significantly, and represent a real risk of loss of life, exsanguination cardiac arrest, or cerebrovascular dysfunction.
There are no devices, available today, which can be used to reliably treat injuries to individuals in the groin, shoulder, neck or other region immediately adjacent to the torso. New devices, procedures and methods are needed to support the strategy of damage control in patients who have experienced massive bodily injury in these regions. Such devices and procedures are particularly important in the emergency, military, and trauma care setting.